Objectives:The lymph node yield of a curative neck dissection for advanced head and neck squamous cell carcinoma (HNSCC) is an important factor in improving patient outcomes. Achieving adequate resection while minimising surgical risk is important. This retrospective study investigated the role of the lymph node yield for the survival of patients with HNSCC.Methods:A total of 234 patients with advanced HNSCC who were treated at a German university hospital between 1997 and 2018 were analysed. The analysis included patient data, tumour-specific characteristics, and the extent of neck dissection performed. Statistical analysis was performed using multivariate Cox proportional hazards models, supplemented by Kaplan–Meier analyses.Results:The median age was 60.0 years (range: 30–85 years, interquartile range: 12.3 years). The follow-up period covered up to 25 years. According to the Union for International Cancer Control,n= 64 patients had UICC-stage III, and 170 patients had UICC-stage IV. The above-average lymph node yield was superior to average, but especially to below-average lymph node yields in bilateral (2.9-fold), ipsilateral (2.6-fold), and contralateral (10.7-fold) neck dissection. In particular, contralateral neck dissection was found to correlate with a significantly better prognosis in terms of overall survival when a higher number of lymph nodes were removed.Conclusions:The study suggests that a thorough and careful neck dissection involving the removal of a greater number of lymph nodes and including the contralateral side could significantly improve the survival for patients with advanced HNSCC.
目的：对于晚期头颈部鳞状细胞癌（HNSCC）患者，根治性颈淋巴结清扫术的淋巴结获取数量是改善患者预后的重要因素。在实现充分切除的同时最小化手术风险至关重要。本研究通过回顾性分析探讨了淋巴结获取数量对HNSCC患者生存的影响。 方法：对1997年至2018年间在德国某大学医院接受治疗的234例晚期HNSCC患者进行分析。分析内容包括患者资料、肿瘤特异性特征及颈清扫范围。采用多变量Cox比例风险模型进行统计分析，并辅以Kaplan-Meier生存分析。 结果：患者中位年龄为60.0岁（范围：30-85岁，四分位距：12.3年）。随访期最长可达25年。根据国际抗癌联盟分期标准，64例患者为UICC III期，170例为UICC IV期。在双侧（2.9倍）、同侧（2.6倍）及对侧（10.7倍）颈清扫中，高于平均水平的淋巴结获取量相较于平均水平（特别是低于平均水平）显示出显著优势。特别值得注意的是，在对侧颈清扫中，更多淋巴结的切除与总生存期的显著改善密切相关。 结论：本研究表明，通过实施更彻底细致的颈淋巴结清扫术，包括扩大淋巴结切除范围及涵盖对侧清扫，可显著改善晚期HNSCC患者的生存预后。
肿瘤(癌症)患者之家